Birthing, like many other things, appears to be susceptible to trends.

Ebs ands flows in the way women birth change with technology and sentiment. Birthing women as early as 1914 were placed into a “twilight sleep” while their husbands were banned from the delivery room. Expectant mothers in that era didn’t so much give birth as much as they awoke to the presence of their infant. And as appealing as that might be to some, the importance of the birth experience slowly crept to center of expectant parenthood and we saw the the importance of a “birth partner,” something that expectant mothers in the 1950s never knew.

C-sections, a procedure initially designed to save the life of mother and baby in cases were vaginal birth is not possible, is now considered standard practice. One in three births in the United States is now performed via c-section, and mostly out of convenience. And as the major abdominal surgery has become even more commonplace, we’ve seen the rise in elective c-sections — or the “too posh to push” epidemic. Scheduling your delivery became a sign of status as the birthing plan of celebrity mothers, such as Victoria Beckham or Britney Spears, consisted of merely choosing a date on the calendar. Women were free to opt out of the “experience” of conventional birth entirely as more and more women, particularly in wealthy metropolitan areas, simply scheduled a c-section.

But with this cultural abhorrence for birth among upper class women, we’re also seeing another option gain more visibility: surrogacy. While the option has helped many many women achieve motherhood who otherwise could not carry a child, the surrogacy choice is also being made by a multitude of women who physically could endure pregnancy, but don’t want to.

Think of famed columnist and writer Alex Kuczynski  who wrote extensively on the cosmetic surgery business after having many procedures herself. In 2006, she grossly concluded in her book Beauty Junkies: Inside Our $15 Billion Obsession with Plastic Surgery:

“…looks are the new feminism, an activism of aesthetics. As vulgar and shallow as it sounds, looks matter more than they ever have — especially for women.”

As laughable as that is to anyone who has even a remote understanding of feminism, Alex is correct when stressing the rising obsession with physical appearance in modern women. In a recent study of a young, professional women in England, nearly half of the participants said that they never wanted a child. Among their many reasons including attachment to their lifestyle, dedication to their careers, and pity for working mothers who attempted to “have it all” was a concern for how pregnancy would negatively affect their appearance. One-third of childless women surveyed said that having a baby would make them “less body confident” — a factor that held a lot of prominence to women with careers.

The cultural fascination with the bodies of celebrity mothers, both pre- and post-baby, was also considered a component in the study. And you don’t necessarily need to be an avid reader of US magazine to understand the media frenzy surrounding pregnant, or suspected to be pregnant, celebrities. The “body narrative” consumes a performer’s entire career once she announces to the press that she is expecting. Everything from her work0out regime to the size of her bump to her post-baby diet is suddenly fodder for the tabloids, despite whatever movie she happens to be promoting in the process. Regardless of other achievements in their careers, suddenly, everything comes down to her body.

In Alex’s case however, she chose surrogacy for reasons other than maintaining her appearance. In 2008, Alex wrote a piece for The New York Times about her decision to use a surrogate after many miscarriages. She recounts that although the reaction to the birth of her son Max was overwhelmingly warm, there was also the sense that she had somehow “cheated” labor in that she attended Bikram yoga classes all through the gestation of her son:

“You’re so lucky. Pregnancy is overrated.” One announced to a table of people at a dinner party: “My God, Alex. You’ve really gotten away with some stuff in your life. But this takes the cake!” It was as if I had performed some slimy trick and was still able to have my ticket stamped “Mother.” Not only Mother, but Biological Mother.

Alex includes a conversation with her lawyer about fertile women opting for surrogacy for the sake of vanity. Her lawyer concludes that many body-conscious women do consider surrogacy at first but ultimately reconsider:

Was not birthing a baby but still having a biological child really “taking the cake”? If so, the birth of Max revealed the ambivalence some women feel about pregnancy. It is a burden. It is scary. Melissa Brisman, our lawyer, told me that occasionally she gets an inquiry from a high-profile model or an actress who is curious about the surrogacy process, she assumes, not for reasons of infertility but for convenience. But once they learn of the physical, emotional and legal intricacies, they always — without exception — decide to bear their own children.

“No one would ever do this out of vanity,” she said. “It’s too overwhelming. The letting go is too overwhelming.”

Yet at the conclusion of her piece, Alex’s husband compares her experience with surrogacy to a c-section in assuring her that the baby is as much a part of her as it is of him.  And although his words are intended to soothe his anxious wife who has thwarted a more traditional trajectory, his comparison to an elective c-section is not completely coincidental:

“You gave birth to our baby,” he told me. “The doctors went in and took our baby out of you 10 months ago.” He was casting back to the day the doctor removed my eggs. “It was like a C-section. They just went in and got him when he was very small. And now he is here, and as much a part of you as if he had come out of your body. Because he did come out of your body.”

Surrogacy is in many ways is akin to the elective c-section in its ability to give women options for birthing. And whether you  choose to bypass the conventional experience completely with a surrogate or with an elective c-section, the routes are there for the taking — especially if you have the means to do so.

Consider then also the recent rise in the visibility of surrogates by some of our most celebrated celebrity mothers. Sarah Jessica Parker, the star of I Don’t How She Does It and deemed “the ultimate working mom” by some chose a surrogate for her two twin daughters. Sarah Jessica’s late in life motherhood dominates the covers of most magazines, tabloid or otherwise, as she speaks about the chaos of scheduling, her decision to not have live-in help, and her continuous “juggling act.”

Elizabeth Banks, 30 Rock star and one of the ensemble cast of What To Expect When You’re Expecting, also chose to have surrogate for her son. More and more privileged, high profile women who dominate our discussion of contemporary motherhood are choosing surrogates, and the stigma for mimicking  Margaret Atwood‘s plot line in The Handmaid’s Tale  is quickly fading.

For women who are already wealthy, successful, and don’t want to birth, “too posh to push” scheduled c-sections may fade with the times, and a new generation of women may spend their 30s not trying to conceive, but scouring for surrogates.

(photo: Shutterstock)